Changing patterns of bladder cancer in the USA: evidence of heterogeneous disease.
Changing patterns of bladder cancer in the USA: evidence of heterogeneous disease.
复制标题
DOI：
10.1111/j.1464-410x.2011.10283.x
复制
发表时间：
2012-01
影响因子：
4.5
通讯作者：
Boyle P
中科院分区：
文献类型：
--
作者：
Zhang Y;Zhu C;Curado MP;Zheng T;Boyle P
为了验证膀胱癌是一种异质性疾病的假设。我们使用国家癌症研究所1973-2007年收集的监测、流行病学和最终结果数据，按组织学亚型、疾病分期和分级检查了膀胱癌的时间趋势。从1973年到2007年，年龄调整的膀胱癌发病率略有下降（年百分比变化[APC] =-0.4，P < 0.05）。虽然非乳头状移行细胞癌的年龄调整发病率由1973年的每10万人7.9人下降至2007年的每10万人3.7人，（APC =-2.2，P < 0.05），乳头状移行细胞癌的年龄调整发病率由1973年的每10万人6.8人上升至2007年的每10万人10.6人，上升约56（APC=0.5，P < 0.05）。在其他少见组织学亚型中，除小细胞癌略有上升趋势外，鳞癌、腺癌等均呈下降趋势。不同阶段（地方、区域和远距离）的情况类似，但1998年至2007年期间，四级呈急剧上升趋势，而一、二级和三级呈相应下降趋势。结果支持膀胱癌是一种异质性疾病的假设，在未来的流行病学研究中考虑疾病异质性是必要的。
To test the hypothesis that bladder cancer is a heterogeneous disease. We examined the temporal trends of bladder cancer by histological subtype and by disease stage and grade using the National Cancer Institute's Surveillance, Epidemiology, and End Results data collected in 1973–2007. The age-adjusted incidence rates of bladder cancer showed a slight decrease from 1973 to 2007 (annual percentage change [APC] = −0.4, P < 0.05). Although the age-adjusted incidence rates of non-papillary transitional cell carcinoma decreased by about 53% from 7.9 per 100 000 in 1973 to 3.7 per 100 000 in 2007 (APC = −2.2, P < 0.05), the age-adjusted incidence rates of papillary transitional cell carcinoma increased by about 56% from 6.8 per 100 000 in 1973 to 10.6 per 100 000 in 2007 (APC=0.5, P < 0.05). Among other rare histological subtypes, except for small cell carcinoma which showed a slightly rising trend, squamous cell carcinoma, adenocarcinoma and others all presented a decreasing trend. Similar patterns were found for different stages (localized, regional and distant), but a dramatic increasing trend of grade IV was found between 1998 and 2007 when a corresponding decreasing trend was shown for grades I, II and III. The results support the hypothesis that bladder cancer is a heterogeneous disease and taking disease heterogeneity into consideration in future epidemiological studies is essential.